Healthcare Spending Highest in the United States

New study creates deja vu all over again (and again, and again…)

patient holds medication to smartphone
Healthcare spending in the United States continues to be nearly twice as much as other countries. Medication adherence technologies could help to lower costs.

In 2016, the United States spent nearly twice as much as 10 high-income countries (primarily members of the Organisation for Economic Co-operation and Development, or OECD) on medical care and while achieving poorer health outcomes, according to a recent study published in the Journal of the American Medical Association. Prices of labor and goods, including pharmaceuticals and devices, and administrative costs appeared to be the main drivers of the differences in spending.

In looking over this recent piece, I wondered if this was simply the same study that we see every year with the dates changed? The “findings” section is always the same for as long as I’ve seen “this” study: spending is higher, but health is poorer.

Of course, this is not the same study merely reprinted year after year, but you get my meaning. I simply do not understand why the U.S. -- one of the richest most innovative countries on Earth -- continues to be complacent with these results.

Since my career in healthcare began, a consistent theme from mentors, bosses, and customers has been “current trends cannot continue.” Yet they have. Persistent and offensive healthcare costs, highly variable quality, less-than-effective legislators, and widening economic inequality are all factors leading healthcare constituents to demand more of the system. In my view, the collective opinion of “this can’t continue,” has been reached.

Medication adherence lowers healthcare costs

One of the most effective, simple, and consumer-friendly ways to lower overall spending is to use medication wisely and take that medication as prescribed. This is not a commercial for the pharmaceutical industry; drug development over the last 50 years represents one of the best examples of technology innovation in the world. We should be using more of the medication we are prescribed and spending less time in hospitals.

However, medication non-adherence is rampant with only about 50 percent of the U.S. maintaining proper adherence.

Adherent healthcare consumers are less costly and have better outcome measures than non-adherent counterparts. All together, this is estimated to add approximately $100 billion to $300 billion to our national healthcare spending. This is seen in the literature across disease state and population.

  • Commercial: Employees with hyperlipidemia that maintain adherence to statin regimens are $5,200 less costly than their non-adherent peers. (1)
  • Medicare: Beneficiaries with Type 2 diabetes that are consistently adherent with medication regimens spend approximately $6,700 less per year in annual healthcare costs. (2)
  • Medicaid: Non-dual beneficiaries with congestive heart failure are $4,000 less costly per year when adherent. (3)

Technology-driven medication adherence solutions

Digital healthcare solutions can drive better results. The emocha Mobile Health platform starts and ends with the patient. Technology and artificial intelligence facilitates engagement, but does not replace true personal interaction, because the relationship between the patient and the provider -- enabled through video Directly Observed Therapy -- drives medication adherence.

Our platform drives 90 to 95 percent medication adherence and has been validated by the CDC, NIH, NIDA, and other sources. Organizations like emocha and others are coming out of the proverbial woodwork and just beginning to drive better outcomes with the adoption of technology in the healthcare industry.

Medication and its proper use represents just one example of innovation in the U.S. healthcare system. It is time to marry digital technologies to medication regimens to ensure proper adherence and offset billions in unnecessary costs.


(1) Sokol, M., McGuigan, K., Verbrugge, R., & Epstein, R. (2005). Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost. Medical Care, 43(6), 521-530. Retrieved from http://www.jstor.org/stable/3768169 Note: Study results trended forward at a conservative commercial medical cost trend of 3% to approximate 2017 levels.

(2) Stuart, B., Loh, F., Roberto, P., & Miller, L. (2013). Increasing Medicare Part D Enrollment In Medication Therapy Management Could Improve Health and Lower Costs. Health Affairs, 32(7), 1212-1220. Healthaffairs.org Note: study results trended forward at 2% Medicare medical cost trend estimate to approximate 2017 levels.

(3) Esposito, M.,Bagchi, A.,Verdier, J. et al. (2009). Medicaid Beneficiaries with Congestive Heart Failure: Association of Medication Adherence with Healthcare Cost and Use. American Journal of Managed Care, 15(7), 437-445, https://www.ncbi.nlm.nih.gov/pubmed/19589011 Note: study results trended forward at 2% Medicaid medical cost trend estimate to approximate 2017 levels.